OV5-C
ANTWOORDKAART / CARTE DE REPONSE /
NAAM
NOM ............................................................................................................................
NAME
ADRES
ADRESSE ...................................................................................................................
ADRES
POSTCODE
CODE POSTAL .......................... LOCALITE ........................................................
POSTKODE
TEL: .........................................................
DEFECT :
DEFAUT :
DEFEKT :
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
ANTWORTKARTE
PLAATS
WOHNORT
6
www.primo-elektro.be